Abstract:

Objective　To explore the effect of graded nursing in the prevention of contrast medium extravasation in dual-source enhanced CT scanning. Methods　This study was a prospective controlled study. A total of 1 646 subjects who received dual-source enhanced CT scanning in the CT room of The 73rd Group Military Hospital from January to August 2021 were selected as a control group, including 894 males and 752 females, aged (48.30±8.65) years. Another 1 682 subjects who received dual-source enhanced CT scanning from September 2021 to May 2022 were selected as a research group, including 912 males and 770 females, aged (48.38±8.79) years. The control group received the routine dual-source CT nursing process; in the research group, the risk grading of contrast medium extravasation was determined according to the subjects' age, times of chemotherapy in the past 3 months, hypertension, times of venipuncture in the past 1 week, and diabetes status, and the graded nursing was performed. The incidence of contrast medium extravasation, the damage grade caused by contrast medium extravasation, and the evaluation of CT image quality were compared between the two groups. Independent sample t test, χ² test, and rank sum test were used for statistical analysis. Results　The incidence of contrast medium extravasation in the research group was significantly lower than that in the control group [0.59% (10/1 682) vs. 1.40% (23/1 646)], with a statistically significant difference (χ²=5.461, P=0.019). There were 9 cases of mild injury and 1 case of moderate injury in the research group; there were 12 cases of mild injury, 11 cases of moderate injury, and 1 case of severe injury in the control group; the damage grade caused by contrast medium extravasation in the research group was significantly lower than that in the control group, with a statistically significant difference (Z=2.159, P=0.031). There was no statistically significant difference in the CT image quality score between the research group and the control group [(2.77±0.45) points vs. (2.75±0.43) points] (t=1.297, P=0.295). Conclusion　The application of graded nursing in dual-source CT scan subjects can reduce the incidence of contrast medium extravasation, reduce the severity of damage caused by contrast medium extravasation, and the quality of CT images has no significant change, which has good application value.

Key words:

Dual-source CT, Enhanced scanning, Contrast medium extravasation, Graded nursing

摘要：

目的　探讨分级护理预防双源CT增强扫描造影剂外渗的效果。方法　研究类型为前瞻性对照研究。选取2021年1—8月第七十三集团军医院CT室接受双源CT增强扫描检查的受试者1 646例作为对照组，其中男894例，女752例，年龄（48.30±8.65）岁；将2021年9月至2022年5月接受双源CT增强扫描检查的受试者1 682例作为研究组，其中男912例，女770例，年龄（48.38±8.79）岁。对照组实施常规双源CT护理流程，研究组根据受试者的年龄、近3个月化疗次数、高血压、近1周静脉血管穿刺次数、糖尿病状况确定造影剂外渗风险分级，并执行分级护理。比较两组检查者的造影剂外渗发生率、造影剂外渗所致损伤分级、CT图像质量评价。统计学方法采用独立样本t检验、χ²检验、秩和检验。结果　研究组造影剂外渗发生率显著低于对照组［0.59%（10/1 682）比1.40%（23/1 646）］，差异有统计学意义（χ²=5.461，P=0.019）。研究组造影剂外渗所致损伤分级：轻度9例，中度1例；对照组造影剂外渗所致损伤分级：轻度12例，中度11例，重度1例；研究组造影剂外渗所致损伤分级显著低于对照组，差异有统计学意义（Z=2.159，P=0.031）；研究组CT图像质量评分与对照组比较差异无统计学意义［（2.77±0.45）分比（2.75±0.43）分］（t=1.297，P=0.295）。结论　分级护理在双源CT扫描受试者中应用可降低造影剂外渗发生率，减轻造影剂外渗所致损伤严重程度分级，且CT图像质量无明显变化，有良好的应用价值。

关键词:

双源CT, 增强扫描, 造影剂外渗, 分级护理